Search

A randomized and controlled study was undertaken to test whether substitution with factor XIII concentrates influences the clinical course in patients with acute leukaemia and acquired factor XIII deficiency (less than or equal to 60%). A control group of 31 patients was compared with a factor XIII-treated group of 29 patients. Partial factor XIII deficiency was successfully corrected by substitution. On the other hand, there was no statistically significant difference between the two patient groups in the frequency and severity of bleeding complications, transfusion requirements, and the number of remissions. Undesirable side-effects as a result of substitution treatment were not observed.

Severe rectal bleeding in a 6-year-old boy with haemophilia A and factor VIII inhibitors could not be stopped with factor VIII concentrates. But a good effect was achieved with activated prothrombin complex concentrates (fraction FEIBA), given over eight days. Amaurosis occurred as a complication after injection of the first dose, but disappeared completely within several minutes. Tests revealed accelerated intravascular coagulation with increased fibrin monomers and fibrin/fibrinogen degradation products.

Hemorrhagic and thrombophilic diathesis are important symptoms in patients with neoplastic diseases. From that point of view it is not surprising that malignancy is often complicated by bleeding or thromboembolism. These clinical manifestations are due to the interaction of the tumor and components of the hemostatic system (platelets, coagulation, and fibrinolytic factors). Specific and adequate therapy of the neoplasm will result in the disappearance of the hemostatic disorder. If no effective antitumor therapy is available drugs may be helpful, which influence the enhanced turnover of clotting factors. Furthermore, platelet transfusions are highly effective in thrombocytopenic bleeding.

A pedicled flap of chest skin is sutured to a tube and interposed between tracheostome and hypopharynx, similar to Asai's method of laryngeal reconstruction. The technique is described, and the dangers and disadvantages are mentioned.

60% of all HIV-infected patients develop neurological deficits during the course of their disease. The facial paralysis of a 47 year old man which presented as a Bell's palsy is nevertheless an unusual first symptom of HIV infection.